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Perforations are the most common and frequent errors that occur during endodontic therapy, especially, in calcified canals and curved canals that affect the prognosis of the affected tooth. The diagnosis of dental pulp and/or periapical tissue previous to root perforation is an important predictor of prognosis along with location and size of exposure. Recently, new materials have been introduced for further improving the chances of a successful outcome when accompanied with the experience and expertise of the practitioner.